Bond For Issuer-Dealer Of Securities Form - State Of Hawaii
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1
2
3State of Hawaii
DEPARTMENT OF COMMERCE AND CONSUMER AFFAIRS
Business Registration Division
335 Merchant Street, Room 203, Honolulu, Hawaii 96813
(808) 586-2722
BOND FOR ISSUER-DEALER OF SECURITIES
Know all men by these presents:
That we,
,
(name of applicant company)
of
as principal,
(applicant's complete principal business address)
and
,
(name of surety company)
of
, as surety,
(surety's complete principal business address)
are held and firmly bound unto the State of Hawaii in the sum of FIVE THOUSAND DOLLARS ($5,000.00), in legal money of the United
States of America, for the payment of which to said State of Hawaii well and truly to be made, we do hereby bind ourselves and our
respective heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.
Witness our hands and seals at
(city and state of principal's execution)
by said
(name of applicant company)
this
day of
, 20
, and at
(principal's execution date)
(city and state of surety's execution)
by said
(name of surety company)
this
day of
, 20
.
(surety's execution date)
Whereas the above bounden principal is an issuer of a security required to be registered and proposes to sell such security in the
State of Hawaii, or, is registered as a dealer in securities in the State of Hawaii, or, has filed with the Commissioner of Securities of the State
of Hawaii an application for registration as a dealer in securities, or is registered as an investment adviser in securities or has filed with the
Commissioner of Securities of the State of Hawaii an application as an investment adviser in securities, in accordance with the provisions of
the Uniform Securities Act (Modified), Chapter 485 of the Hawaii Revised Statutes.
The condition of this obligation is such that if the bounden principal and/or all of the salespersons or investment adviser
respresentatives registered by and acting for him, shall fully and faithfully comply with the provisions of the Uniform Securities Act (Modified),
Chapter 485 of the Hawaii Revised Statutes, then this obligation shall be void, otherwise to be and remain in full force and effect.
And, the surety, herein may cancel this bond and be relieved of any future accruing liability hereunder by giving sixty (60) days
notice in writing of its desire to do so to the Commissioner of Securities, State of Hawaii.
S-5
(OVER)
Rev. 03/04
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